Here's a thought to curdle the blood: on any given night, about one in five men here above the age of 30 will stop breathing for at least 10 seconds during his sleep - not once but multiple times.
The new apnea graph study is
painless and accurate.
Painless, accurate: The new apnea graph study is a painless process, and gives accurate information about the severity of one's apneic condition as well as the location of the obstruction
Apnea, which in Greek literally means without breath, is quite a common affliction. In fact, the American National Institute of Health reckons that sleep apnea is as common as adult diabetes.
'Typically, patients with apnea will stop breathing for much longer than 10 seconds. Each episode can actually last between 30 and 60 seconds,' says Stephen Lee, consultant ENT surgeon at Raffles Hospital.
The dangers of sleep apnea are two-fold - on an immediate level, patients who suffer from apnea can experience varying degrees of tiredness the following day with lapses in concentration, even dozing off at critical moments. In the long term, untreated sleep apnea can be life threatening.
'Left untreated, in time to come, sleep apnea will increase the risk of many conditions. For example, the risk of hypertension is two to five times higher, while the risk of heart attack is 23 times higher,' says Dr Lee, who adds that men are more prone to the condition than women.
There are two common types of apnea - obstructive and central. Obstructive sleep apnea is caused by a blockage of the airway, usually when the soft tissue in the rear of the throat collapses and closes during sleep. In central sleep apnea, the airway is not blocked but the brain fails to signal the muscles to breathe.
Diagnosis of the condition used to be tedious and subjective, but there is a new diagnostic kit in town that costs much less discomfort.
'Traditionally, when sleep apnea is suspected, doctors will suggest the patient undergo a sleep study. This involves a night's stay in hospital and requires the patient to be all hooked up,' explains Dr Lee.
Called a polysomnography, this process records a patient's night-time breathing, brain and physical activity. Several electrodes will be pasted to the patient's head to measure brain electrical activity with an EEG. Electrodes are also taped to the skin near the outer edges of the eyes, and another device is placed near the patient's nose and mouth to measure airflow.
The entire process is cumbersome and cost about $1,500. Somewhat cheaper and much more convenient is the new apnea graph study.
'The best thing about the new technique is that patients need not stay over in hospital. The patient will come into the clinic in the evening to have a small catheter inserted through the nose, and the data recorder is small enough to fit into his pocket,' explains Dr Lee, who has done 13 such studies since May this year.
The entire process lasts only a few minutes, and there's no pain, according to Dr Lee. The 2-mm-thick catheter contains two pressure sensors and two temperature sensors. These sensors will record data throughout the night, in the comfort of the patient's own home.
'In fact, after insertion the patient could eat and drink normally,' Dr Lee promises.
Obstructive sleep apnea is usually diagnosed if the patient has an apnea index greater than five, that is, if he has more than five apneic episodes per hour.
The apnea graph, which was developed and tested successfully in Europe, is able to give accurate information regarding the severity of the condition, as well as the location of the obstruction.
Such information will influence the choice of treatment and its eventual outcome, says Dr Lee.
'In some cases, where the obstruction occurs in the upper levels such as in the nose or palate, surgery will be a good option,' he explains.
Since not all cases of sleep apnea will benefit from surgery, an accurate diagnosis will save the patient time, money and unnecessary surgical pain.
Apart from surgery, treatment options include weight reduction, positional therapy, positive pressure therapy and oral appliances.
Typically, therapy involves the wearing of a special mask that will 'force' air through the airways during sleep.
'The nasal or full-face mask is strapped around the head, and it is connected to a pump that will take in room air and push it into the lungs under positive pressure,' says Dr Lee.
Since weight adds to the problem, Dr Lee advises that those who suffer from apnea should try losing some weight.
'Obesity itself doesn't cause sleep apnea, but it often does contribute to the problem,' he says.
Other than weight loss, other unsavoury lifestyle habits such as smoking and drinking will also have to go. But what won't you give for a good night's sleep?
As a popular Irish proverb goes, a good laugh and a long sleep are the best cures in the doctor's book.
